Healthcare Provider Details

I. General information

NPI: 1730168394
Provider Name (Legal Business Name): MICHAEL K MILLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 HOLLY HILL LN STE 301
GREENWICH CT
06830-2918
US

IV. Provider business mailing address

560 WHITE PLAINS RD
TARRYTOWN NY
10591-5113
US

V. Phone/Fax

Practice location:
  • Phone: 203-365-0770
  • Fax: 203-635-0771
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number221510
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number43010
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: